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Fibromyalgia (FM) syndrome in children & adolescents: clinical features at presentation & status at follow-up

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OBJECTIVES: To 1) describe the characteristic features of

fibromyalgia syndrome (FS) in a pediatric population, 2) note

similarities and differences with FS in adults, and 3)

determine outcome after treatment.


Pediatric Rheumatology Clinic at the University of Rochester

Medical Center is staffed by two pediatric rheumatologists and

serves as a regional subspecialty referral service with

approximately 450 annual patient visits, of which

approximately 120 are initial evaluations. A retrospective

medical record review from 1989 to 1995 was used to identify

and describe the study population, and a structured telephone

interview served to determine current status and response to


RESULTS: A total of 45 subjects were identified (41

female; 42 white; mean age, 13.3 years), of whom 33 were

available for telephone interview at a mean of 2.6 years from

initial diagnosis (0.1 to 7.6 years). Of a possible 15

symptoms associated with FS, subjects reported a mean of 8,

with >90% experiencing diffuse pain and sleep disturbance.

Less frequent were headaches (71%), general fatigue (62%), and

morning stiffness (53%). The mean cumulative number of tender

points summed over all visits was 9.7 (of 18). Telephone

interviews showed improvement in most patients, with a mean

positive change of 4.8 on a self-rating scale of 1 to 10

comparing current status to worst-ever condition.


FS in patients referred to a pediatric rheumatology clinic is

characterized by diffuse pain and sleep disturbance, the

latter being more common than that in adults. The mean number

of tender points summed over all visits is fewer than the

criterion of 11 established for adults at a single visit. The

majority of patients improved over 2 to 3 years of follow-up.

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